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Radiotherapy

If your tumour is in a position which makes surgery too risky to perform, radiotherapy may be used as a first line of treatment, usually in combination with Chemotherapy. For some people with low-grade gliomas, these treatments may be offered soon after diagnosis; for others it could be that their tumours are stable enough for years to pass by on the â€œwatch and liveâ€ treatment plan of regular MRI scans before any radiotherapy is offered.

If your tumour is suitable for surgery, it is not guaranteed that all of the tumour cells can be removed completely without interfering with normal brain structures and running the risk of causing permanent damage; so the surgeon will stop when he considers further surgery to be too risky, and you will have experienced a â€œpartial resectionâ€. Unfortunately, even if the entire tumour seems to have been removed (a â€œcomplete resectionâ€) small cells may remain behind, which are not able to be detected at the time. Brain surgery can usually be undertaken on more than one occasion if your tumour grows back (we have people on our online support group who have had surgery 2 or 3 times), but there may come a time when your Neuro-oncologist recommends radiotherapy as the next line of treatment.

Some tumours are very sensitive to radiotherapy and the hope is for a cure. Other tumours are less sensitive to it, and in such cases it may not be possible to cure, but radiotherapy will usually bring relief of symptoms and prolong life. For example, you may notice a considerable reduction in the frequency and severity of seizures; or a lessening of mobility problems. However all radiotherapy to the brain carries a risk of side effects, some of which may be temporary and others permanent.

Your neuro-oncologist will advise when is the best time for you to consider radiotherapy, as it can usually be used only once. However exceptions to this are:

if your first radiotherapy treatment was a number of years ago (for example 10 years ago)

if a Brain Tumour arises in a different part of the brain and can be treated by another form of radiotherapy such as stereotactic radiotherapy (gamma knife)

This article has been reviewed by Russell Fitchett, Superintendent Radiographer, Norfolk and Norwich University Hospital.

The sections below give you further information on the mask making process, what to expect during conventional radiotherapy, possible side effects and details on other types of radiotherapy.